strategic plan 2018-2020 - norton county hospital · 2018-12-21 · strategic plan. response totals...

STRATEGIC PLAN 2018-2020

2

Purpose

The purpose of this plan is to guide future priorities and

decisions for Norton County Hospital to expand its scope

during the years 2018-2020. The plan addresses four focus

areas: Facility Status and Condition, Funding and Public

Financial Support, Recruitment and Retention, and Regional

Engagement and Needs.

Plan Format Strategic Focus Areas: Based on themes derived from

data and stakeholder input, these areas are the focus of

planning efforts.

Goals and Objectives: Based on discussions of “what

success would look like” for each focus area, goals represent

an overall desired end-result, and objectives provide specific

results to be achieved.

Dashboard Measures: Methods to track desired changes

in productivity, effectiveness, efficiency, and/or resource

acquisition.

Health Needs: Numbered topics highlighted in the

Community Needs Health Assessment that informed the

focus area.

Strategies: The general means or methods used to arrive

at the desired goal.

First Step Action Plans: First steps to operationalize

strategies, associated with champions to facilitate the

change effort, and a proposed timeline for the activity. This

is to encourage using what is learned to adopt, adapt, or

abandon tactics over time.

Champions: For each strategy, the person(s) who will

initiate steps, track progress, and engage others in ongoing

strategic thinking and doing.

3 From the Director

5 Data Overview

11 Strategic Focus Area 1




19 Timeline

20 Moving Forward

3

From the

Administrator

Gina Frack

Norton County Hospital

Chief Executive Officer

Norton County Hospital is a critical access hospital in northwest Kansas that serves residents of Norton

County and the surrounding area in both Kansas and Nebraska. The community served by the Hospital

is determined, in large part, from its organization and status as a county hospital pursuant to state

statute. In respect to the values of caring for our patients and residents, commitment to improving the

quality of our care and providing communities in the region with health care that is relevant to their

needs, we conducted this strategic planning process with the Norton County Health Department and

Norton Regional Health Foundation.

The purpose of this strategic and implementation plan is to guide future priorities and decisions for

Norton County Hospital over the years of 2018-2020. This document will be for public knowledge and

referenced consistently both within the organization and as a part of community engagement. It is

considered a living document that will be modified as circumstances change and the future unfolds.

The strategic planning effort stretched more than 10 months in an effort to collect input from as diverse

of representation of our patients and region as possible, including input received from uninsured or

underinsured community members. This was done by the following methods utilizing Wichita State

University Community Engagement Institute facilitators and Wichita State University Center for Applied

Research and Evaluation researchers:

- A community survey for the Community Health Needs Assessment (CHNA) was promoted for all

residents in our service area to complete. It was distributed in a variety of online methods as well

as by hard copy in May and June 2018.

- A public forum reviewing the CHNA findings and gathering additional input from the attendees

was hosted in July 2018.

All eight health concerns/needs in the CHNA are addressed in the strategic and

implementation plan.

- A stakeholder engagement meeting reviewing hospital data, health care trends and the findings

from the CHNA yielded focus areas to be considered moving forward. This meeting was hosted

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in late October 2018 with about 50 community members. Initially, six focus areas were identified

and then condensed to four. These are the same focus areas seen here in the strategic and

implementation plan.

- The staff at the Norton County Hospital and Norton Medical clinic were then given a survey to

address the four focus areas reflecting the top community health needs as identified at the

stakeholder engagement meeting. They answered the five questions listed below.

What should Norton County Hospital keep in mind in the area of Facility Status and

Condition?

What should Norton County Hospital keep in mind in the area of Funding and Financial

Support?

What should Norton County Hospital keep in mind in the area of Recruitment and

Retention of Providers?

What should Norton County Hospital keep in mind in the areas of Community

Engagement and Needs?

What is missing in this planning discussion so far?

- A dozen staff with diverse roles met for a day to develop goals, objectives and ways to measure

success; assure all health needs in the CHNA are addressed; and develop strategies, identify first

steps and name champions for each strategy. It was a long but very productive day.

All the hard work by staff, the board and community members have led us to this place. In short, through

this process, the community identified four focus areas or top community health needs, including: (1)

have facilities that meet emerging health care needs of the region; (2) maintain strong public financial

support and other diversified resources to meet the needs of patients, the communities served and

hospital/clinic staff; (3) attract and develop qualified providers and staff with long-term commitment to

the hospital and clinic; and (4) respond to the fact Norton County depends on the Hospital for much of

its health-related needs. We now have identified the significant health needs of the community, created

an implementation strategy to address those needs, and prioritized our next steps for the immediate

future.

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Data Overview This strategic plan was informed by multiple sets of data including:

- Community Health Needs Assessment (page 5)

- Hospital Trend Data (page 6)

- Staff Survey (page 10)

Prior to developing the Strategic Plan, the Wichita State University Community Engagement Institute

conducted a Community Assessment of Norton County on health and related issues. A total of 354

surveys were analyzed and synthesized into the following primary health concerns/needs for Norton

County:

1. A need for better access to health care in Norton – Good access to health care was most important

to respondents in creating a healthy community.

2. Improvement needed in the availability of mental/behavioral health care – Mental and

behavioral health were considered by respondents the third greatest impact on community health.

3. Cost of care is a barrier – Affordable health care was considered the greatest need for community

health by respondents overall, with 72% putting it in the top three needs.

4. Appointments and services with specialists are in short supply locally, if at all – Seeing the

specialist(s) they needed was the top reason that respondents received care outside of Norton County.

5. Quality of care in Norton is an issue for nearly half of respondents – Forty percent (40%) of

respondents seeking health care outside of Norton indicated they do so because they receive a higher

quality of care.

6. There is concern about health care organization leadership in Norton – This came up in open-

ended responses as it was not specifically targeted in survey questions.

7. The community is impacted by health issues due to aging – Fifty percent (50%) of respondents

placed this in the top three greatest impacts on community health.

8. Cancer was the condition listed as having the greatest impact on community health – Fifty-eight

percent (58%) of respondents put this in the top three impacts on community health.

Each number, 1-8, corresponds with the ‘Health Needs’ section under each Focus Area.

Community Health Needs Assessment

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In October 2018, Norton County community leaders, hospital staff, and residents reviewed the

Community Assessment findings and the following trend data, put together and presented by hospital

staff:

Public Funding: This graph shows the amount and type of financial support for the critical

access hospital in Norton County and surrounding Kansas Counties in the way of local tax and/or

sales tax.

Hospital Trend Data

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Norton County Hospital Inpatient and Outpatient Revenue: This graph

shows the increasing revenue coming from outpatient services at Norton County Hospital.

Norton County Hospital Payer Mix: Payer Mix shows from which sources Norton

County Hospital receives payment for patient services and the trend over time.

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Norton County Hospital Age of Plant: The age of the physical structure, mechanical

(ex. HVAC, plumbing, and wiring) and equipment assets of the hospital is an indicator of the

financial position of the organization. The older the average age, the greater the short-term

need for funds to cover repairs, replacement and maintenance. This graphic compares Norton

County Hospital to other critical access hospitals in Kansas and the nation.

Norton County Hospital Days Cash on Hand: Simplistically this represents the

amount of cash available. Hospitals usually balance the amount of days cash on hand by tying

their strategic plans to their capital plan and budgets and projecting how much cash is needed.

This graphic also compares Norton County Hospital to other critical access hospitals in Kansas

and the nation

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Norton County Hospital Operating Margin: Operating margin is a profitability

indicator. It shows the income received from only patient care operations. This doesn’t include

other revenue sources such as tax support, grants and/or donations. This graphic compares

Norton County Hospital to other critical access hospitals in Kansas and the nation.

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As a result of the stakeholder meeting in which the community assessment and hospital trend data were

presented, 4 focus areas were decided upon for Norton County Hospital. A short survey was created and

sent out to staff to gain input on each focus area to further inform focus areas and strategies for the

strategic plan. Response totals for each question ranged from 13 to 30, with an average of 24 respondents

per question. The survey was composed of five open-ended questions and resulted in the following

responses:

1. What should Norton County Hospital keep in mind in the area of Facility Status and Condition?

There was unanimous agreement that NCH facility equipment is outdated and in need of updates.

Areas to prioritize included surgery/OR, kitchen/dietary, general surface updates, navigation, and

accessibility.

2. What should Norton County Hospital keep in mind in the area of Funding and Financial Support?

Responses for this question fell into 3 categories:

- Increase local funding support through tax/mill levy increases, fundraising, bonds, grants, and

donations.

- Improve staffing practices by focusing on retaining current staff and maximizing employee

potential.

- Improve community relations and reputation through more community service engagement and

higher transparency.

3. What should Norton County Hospital keep in mind in the area of Recruitment and Retention of

Providers?


- Reduce turnover by treating staff better and offering rewards and incentives.

- Improve workplace culture and management by creating a positive environment through higher

senses of trust and ownership.

- Recruit and hire providers by addressing turnover, providing incentives, and recognizing the

community’s role in attracting providers.

4. What should Norton County Hospital keep in mind in the area of Community Engagement and

Needs?


- Rebuild community trust – inform community and provide transparency.

- Engage in more community activities.

- Improve poor reputation due to poor employee treatment and high turnover.

5. What is missing in this planning discussion so far?


- Focus on caring for current employees.

- Inform staff about changes at NCH and provide opportunities for involvement in processes.

Staff Survey

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Strategic Focus Area 1

GOAL

Norton County Hospital’s facility meets the emerging health

care needs of the region (form follows function).

OBJECTIVES

Increase community and partner support for assessing

and addressing hospital facility needs.

Improve access to high-quality medical services.

Witness hospital capacity for state-of-art equipment and

procedures.

Increase in number of people utilizing services (market

share).

DASHBOARD

MEASURES

HEALTH

NEEDS

Number of region-wide community meetings to identify

health care needs

Unduplicated census at public engagement activities

People utilizing services at the hospital (market share)

Public financial support for the hospital

1. Better access to health care in Norton

5. Quality of care in Norton

Facility Status and Condition

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1.1 Share messages/facts about the current status of the hospital (finances,

facility, services, staffing) and assess support for the hospital. [Timeline: January 2019 – January 2021]

1.1.1 Prepare messages/facts that tell the story of the hospital’s past, present, and

future status (where we’ve been, where we are, and where we need to go in

comparison with benchmark communities).

1.1.2 Equip staff with talking points and message materials to informally share with

the community.

1.1.3 Conduct education activities including:

- Series of community and in-house meetings to share messages and

assess support for the hospital

- Social media communication

- Health care provider communication

1.1.4 Provide positive patient experience stories and health outcome statistics.

1.2 Study feasibility of new building, expansion, repurposing and other options

including co-location. [Timeline: July 2019 – January 2020]

1.2.1 Assessment of regional health care needs and desires.

1.2.2 Analyze community utilization trends including facility classification

comparisons.

1.2.3 Study what’s working in benchmark communities.

1.2.4 Conduct financial feasibility assessment of current operations and options to

meet voiced regional needs.

1.3 Explore existing and potential opportunities to negotiate partnerships that

inform the design, increase the demand, and promote sustainability of the

hospital facility. [Timeline: March 2019 – January 2020]

1.3.1 Identify peer hospitals that have partnerships in place and assess pros and

cons (partnerships can include: informal, collaborative, partnership

agreements, resource sharing, co-location of services, etc.).

1.3.2 Establish criteria for a ‘good partnership’ for Norton County Hospital and the

region. Identify potential partners and initiate discussions.

1.3.3 Based on feasibility, determine whether or not to initiate negotiations.

STRATEGIES AND

ACTION STEPS

1.1 Lead – CEO, CFO, Foundation Director

1.2 Lead – CFO, Engineering Manager, Rehabilitation Manager, Possible Vendor Support

1.3 Lead – CEO, Board of Trustees Representative, medical Staff Representative, CFO

CHAMPIONS

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GOAL

Norton County Hospital has strong public financial support and

other diversified resources to meet the needs of patients, the

region, and hospital/clinic staff.

OBJECTIVES

Use hospital resources effectively and efficiently.

Increase funding for personnel, services, and technology.

Increase perception of hospital stability to promote financial

support.

Increase diversity of hospital funding sources.

DASHBOARD

MEASURES

HEALTH

NEEDS

Percentage of income by source

Profit-loss

Non-service generated income

3. Cost of Care

Funding and Public Financial Support

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2.1 Increase regional funding support.

[Timeline: November 2018 – February 2019, November 2019 – February 2020,

November 2020 – January 2021]

2.1.1 Prioritize fundraising opportunities based on the strategic plan and

communicate priorities to donors and potential donors.

2.1.2 Refocus grant writing efforts based on strategic planning priorities.

2.1.3 Initiate an employee giving program with incentives.

2.1.4 Based on success of strategy 1.1, seek increased tax support.

2.2 Promote a sustainable hospital environment. [Timeline: July 2018 – January 2021]

2.2.1 Assess, develop, and utilize current employees’ capacities to

increase effectiveness and morale.

2.2.2 Address and improve staff trust, sense of ownership, and retention

(see 3.2.2).

2.2.3 Maximize cost-sharing service opportunities (CFO).

2.3 Create a stable provider network including specialty clinics. [Timeline: March 2018 – January 2021]

2.3.1 Explore existing and potential opportunities to negotiate

partnerships (see strategy 1.3).

2.3.2 Recruit and retain providers (see focus area 3).

STRATEGIES AND

ACTION STEPS

2.1 Lead – Foundation Director, Foundation Board Representative, CEO, Medical

Clinic Manager, Risk Manager

2.2 Lead – HR Manager, Risk Manager, Medical Clinic Coding, Director of Nursing

2.3 See strategies/areas sited above

CHAMPIONS

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GOAL

Norton County Hospital attracts and develops qualified

providers and staff with a long-term commitment to the

hospital/clinic.

OBJECTIVES

Improve sense of support and connectivity among providers

and staff.

Create new opportunities for provider/staff recruitment and

retention.

Enhance menu of recruitment and retention incentives.

DASHBOARD

MEASURE

HEALTH

NEEDS

Turnover and retention rates

Provider recruitment (contracts)

Health care Provider Shortage Area score

Contracted service costs

4. Short supply of specialists appointments

6. Health Care organization leadership in Norton

Recruitment and Retention

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3.1 Develop regional efforts that promote recruitment.

[Timeline: December 2018 – January 2021]

3.1.1 Develop a business leaders’ task force that identifies possibilities for

incentives.

- Utilize Economic Development partnerships to identify business

leaders, organizations, etc.

3.1.2 Develop outreach efforts and a range of opportunities for staff

spouses/families.

3.2 Explore best way to incentivize long-term commitment. [Timeline: July 2018 – October 2018]

3.2.1 Reach out to peer hospitals and research best practices for

incentivizing long-term commitments.

3.2.2 Work with local foundations and others to explore new opportunities

to fund incentives (tuition reimbursement, longevity bonuses, etc.)

3.2.3 Explore and study ways to foster a positive workplace culture.

- On-call scheduling

- Work-life balance

- Policies

- Respect and valuing employees

- Internal organizational communication

3.2.4 Create community integration opportunities for providers and staff.

3.3 Develop current employees to fill needed positions. [Timeline: July 2019 – January 2021]

3.3.1 Find ways to have discussions around employee development goals

and strategies (link goals to current staffing needs).

3.3.2 Develop career tracks (plans) including staff development

opportunities.

STRATEGIES AND

ACTION STEPS

3.1 Lead - Director of Nursing, Administrative Assistant, Board of Trustees

Representative, Economic Development representatives (Norton County and

Regional)

3.2 Lead - Medical Clinic Coding, CEO, Director of Nursing, HR Manager, Foundation

Director

3.3 Lead - HR Manager, HR Partners, CIO

CHAMPIONS

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GOAL

Norton County region looks to Norton County Hospital for all health-

related needs.

OBJECTIVES

Norton County community looks to the hospital as a trusted and credible

organization.

Norton County Hospital collaborates with other providers to offer

integrated services.

Hospital and Health Department staff are better able to communicate

regional health-related needs and how their organizations address those

needs.

DASHBOARD

MEASURE

HEALTH

NEEDS

Percentage of Norton County community using Norton County services

New services and additional integrated services provided in Norton

County

Measured improvement on community assessment related to perceived

quality of care.

2. Availability of mental/behavioral health care.

5. Quality of care in Norton

7. Community Impact of health issues due to aging.

8. Cancer has the greatest impact on community health.

Regional Engagement and Needs

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4.1 Integrate health services. [Timeline: July 2019 – January 2021]

4.1.1 Study the gap between needs and resources for areas identified in the

2018 needs assessment and market analysis, including but not limited

to:

- Behavioral Health

- Oncology

- Substance Abuse

- Aging population needs

4.1.2 Develop cross-sector work groups to address findings of gap analysis,

best practices, integrated programs to address identified needs, etc.

4.1.3 Seek funding strategies to develop programs.

4.2 Improve confidence and positive experiences with patient

care/encounters. [Timeline: July 2018 – January 2021]

4.2.1 Identify areas of daily patient care/encounters that can be improved.

4.2.2 Address findings by standardizing processes throughout the facility

based on best practices.

4.2.3 Strategically communicate to staff and public efforts to improve care

and positive results.

4.3 Collaborate with the Norton Regional Health Foundation and County

Health Department to lead promotion of healthy living in the region. [Timeline: January 2018 – January 2021]

4.3.1 Identify other partners in this effort.

4.3.2 Reach out to other peer hospitals to gain information on community

activities.

4.3.3 Develop a plan to initiate higher levels of internal organizational and

regional engagement.

4.3.4 Lay the groundwork for future healthy organizational and public policy

development.

STRATEGIES AND

ACTION STEPS

4.1 Lead - Outpatient Coordinator, Surgery Director, CEO, Health Coach, Norton County Health

Department representative, High Plains Mental Health representative, Valley Hope

representative

4.2 Lead – CIO, Medical Clinic Manager, PFAC (Patient and Family Advisory Council)

representative, Risk Manager, Lab Manager, Radiology Manager, Cardiac Rehab Manager,

Rehabilitation Manager, Shared Governance

4.3 Lead - Trauma/Safety/Emergency Preparedness Coordinator, CEO, Foundation Director, Live

Well Norton Representative, Norton County Health Department representative

CHAMPIONS

19

Timeline 2018 2019 2020

Jan. May Sept. Jan. May Sept. Jan. May Sep

Focus Area 1: Facility Status and Condition

Strategy

1.1:

Share messages/facts that tell the story of the

hospital’s past, present and future status.

Strategy

1.2:

Study feasibility of new building, expansion,

repurposing and other options including co-

location.

Strategy

1.3:

Explore existing and potential opportunities to

negotiate partnerships that inform the design,

increased demand, and promote sustainability of

the hospital facility.

Focus Area 2: Funding and Public Financial Support Strategy

2.1:

Increase regional funding support

Strategy

2.2:

Promote a sustainable hospital environment.

Strategy

2.3:

Create a stable provider network including

specialty clinics.

Focus Area 3: Recruitment and Retention

Strategy

3.1:

Develop regional efforts that promote

recruitment.

Strategy

3.2:

Explore best way to incentivize long-term

commitment.

Strategy

3.3:

Develop current employees to fill needed

positions.

Focus Area 4: Regional Engagement and Needs

Strategy

4.1:

Integrate Health Services

Strategy

4.2:

Improve confidence and positive experiences with

patient care.

Strategy

4.3:

Collaborate with the Regional Health Foundation

and County Health Department to lead promotion

of healthy living in the region.

January 2019 – January 2021

11.18 –

02.19

July 2019 –

Jan. 2020

March 2019 –

January 2020

11.19 –

02.20

11.20 –

02.21

January 2018 – July 2021

July 2018 – January 2021

December 2018 – January 2021

07.18 –

10.18




January 2018 – January 2021

20

Moving Forward

This plan aligns with the Norton County Hospital’s historical tagline: Caring, Commitment,

Community is lived each and every day. The strategic planning effort was informed by stakeholder

input, as well as data related to trends, conditions, challenges, and opportunities.

A first and crucial step to ensuring a strategic plan’s effectiveness is clearly communicating the roles

of stakeholders. When they understand their roles, stakeholders actively work together to implement

strategies, learn from their efforts, adapt, and continue to move forward until the desired outcomes

are accomplished. During the planning process, champions were identified for each focus area

strategy. These leaders will not necessarily be the ones doing the work associated with their named

strategy; instead, they will facilitate the work. Performance measures will be used to track changes

in productivity, effectiveness, and/or efficiency. Over time, Norton County Hospital will be able to

see progress towards objectives in each focus area, leading the organization to achieve their overall

desired end-results.

This strategic plan will be a living document. Updates will constantly inform, and perhaps change,

the course of the plan. Adaptability insures that the organization may stay attuned to the needs of

its stakeholders—patients and their families, staff, volunteers, donors, and regional citizens at large.

These recommended steps will help to insure Norton County Hospital makes progress toward stated

goals and objectives:

The Norton County Hospital Board of Trustees, serving in a governance capacity, should

review, revise as needed, and approve the plans.

Ongoing strategic ‘thinking and doing’ is required if any progress is to be made toward goals

and objects. WSU has provided (separately) a 90-120 Day Strategic Thinking and Doing

Worksheet. This tool can guide the work of leaders as they implement strategies, monitor

progress, and adapt strategies based on what is learned.

A design team, composed of Hospital leadership and members from the Wichita State University

Community Engagement Institute, facilitated this planning process.

Norton County Hospital

102 E Holme, P.O. Box 250

Norton, KS 67654

785-877-3351

Norton Medical Clinic

807 N State St., P.O. Box 408

Norton, KS 67654

785-877-3305

strategic plan 2018-2020 - norton county hospital · 2018-12-21 · strategic plan. response totals...

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